Do You *Really* Need to Avoid Certain Foods While Breastfeeding?
Here's a case for ignoring your judgy MIL: There’s almost no scientific evidence to back up these long lists of foods to avoid while breastfeeding. In fact, the CDC’s official stance is that, “Generally, women do not need to limit or avoid certain foods while breastfeeding. Mothers should be encouraged to eat a healthy and diverse diet.” Individual babies may have specific reactions to a particular item or ingredient, but for the most part, there are no foods that negatively affect all babies.
Lori Feldman-Winter, MD, MPH, and chairperson of the American Academy of Pediatrics’ breastfeeding division, echoes this sentiment. “Basically, a breastfeeding mom can eat the same foods she did during and before pregnancy,” she says. Yet sadly, a small 2017 study found that most women were unnecessarily restricting their diets while breastfeeding. The most commonly-avoided foods while breastfeeding, according to the study, were caffeine and spicy foods—even though there is limited evidence to support cutting out those foods completely. It's safe to say that there's a LOT of confusion out there.
The short version: Your number one focus while breastfeeding should on getting the nutrients you and your baby need (and in fact, breastfeeding moms generally need to eat 400 to 500 more calories a day, per the CDC). How you choose to get those nutrients is up to you. “Babies actually prefer the foods and flavors that mom consumes during pregnancy and lactation once they begin to eat [solid food], after six months,” Dr. Feldman-Winter says. Translation: If you want your baby to enjoy a wide variety of healthy foods when they get older, it's a good idea to eat a variety of ingredients and flavors yourself.
That said, experts say there are a few select foods that should be limited or avoided while you are breastfeeding. But the list of no-no's definitely isn't as long as those scary mommy forums make them out to be.
Keep reading for the legit foods to avoid while breastfeeding, as well as the ones that you definitely should feel free to continue enjoying.
Best avoided: Alcohol
For the most part, “alcohol use should be discouraged in breastfeeding women,” Dr. Feldman-Winter says. “Research has shown that breastfeeding babies of moms who have more than two drinks a day will consume less breast milk, may have trouble gaining weight and growing, and risk neurodevelopmental delays.”
But indulging in a few glasses of vino a week probably won’t do any harm. “Moms may safely consume one drink per day and then wait two to four hours for the alcohol to clear from the milk before nursing,” Dr. Feldman-Winter says. (Keep in mind that “one drink,” as defined by the CDC, equals 5 oz. of wine, 12 oz. of beer, or 1.5 oz. of hard liquor.) And if you do choose to have a glass of wine or a cocktail, Dr. Feldman-Winter says not to bother with pumping and dumping. “Blood levels equilibrate with the levels in milk, and pumping does not facilitate clearance [of alcohol],” she explains.
Best avoided: High-mercury fish
The USDA recommends eliminating high-mercury fish like king mackerel, tilefish, and swordfish completely while breastfeeding, and limiting your consumption of canned white tuna to less than 6 ounces a week. This is because mercury (a harmful chemical that can damage a baby's developing brain and nervous system) can be passed to your baby in small amounts through breast milk.
Thankfully, most fish are perfectly safe to consume, and, thanks to their concentration of heart-healthy fats, are a valuable addition to your diet. Stick to two to three 4-ounce servings a week of low-mercury varieties like salmon, tilapia, and trout, per the FDA's guidelines. (For a handy, printable guide to smart seafood choices, check out this brochure from the Natural Resources Defense Council.)
Okay in small amounts: Caffeine
If you’re one of those “don’t talk to me until I’ve had my coffee” types, we have some good news—experts say there’s no need to give up your habit just because you’re breastfeeding. According to the American College of Obstetricians and Gynecologists, moderate amounts of caffeine (200 mg per day, or two 8-ounce cups of coffee) likely will not affect your baby while breastfeeding. But if you’re somebody who sips coffee all day long (or whose go-to order is a Venti), it’s a good idea to cut back for now.
Keep eating: Broccoli, cabbage, and other "gassy" foods
Despite what you may have heard, there’s no truth to the claim that a baby whose mother consumes fibrous veggies will end up feeling gassy or fussy. “Food high in fiber may cause gas in the mother, but there is no evidence that they cause any problems in the breastfeeding baby,” says Dr. Feldman-Winter.
If your baby is gassy, that’s probably a result of very natural human processes—processes that breastfeeding might actually help strengthen. “Gas is produced by the bacteria that live within the intestine, and [the bacteria are] shaped in the most healthy way through exclusive breastfeeding,” Feldman-Winter adds. If mom is eating fiber-rich foods that give her microbiome a boost, a breastfeeding baby’s microbiome will be “highly correlated with mom’s own,” she notes.
Keep eating: Peanuts
For starters: Current government guidelines recommend introducing peanuts to children as young as four to six months old in order to reduce the risk of developing a peanut allergy, depending on their risk level for developing a peanut allergy. However, there are no guidelines restricting women from eating food with peanuts while breastfeeding.
The thinking used to be that even limited exposure to peanuts via mom’s breast milk could cause a peanut allergy to develop. But recent research suggests that the exact opposite may be true. One study by experts at Boston Children’s Hospital found that nursing mice who were exposed to food allergens passed on important, allergy-preventing antibodies to their offspring. The effect was even more pronounced if the babies had also been exposed to those same allergens during their mothers’ pregnancy.
The benefits seem to extend to human subjects, too. A seven-year study of 545 children published this year in the Journal of Allergy and Clinical Immunology found that the group who were exposed to peanuts very early on, including while breastfeeding, were the least likely to develop allergies. So if you're not allergic to peanuts, there's not a proven reason to avoid eating them while breastfeeding.
Keep eating: Spicy or garlicky foods
If you normally pour Sriracha on everything, you're okay to continue doing that while breastfeeding. “Again, there’s no evidence that spicy or garlicky foods cause problems in the baby,” Dr. Feldman-Winter says. “Typically, foods consumed by a mother before and during pregnancy will be tolerated by both mother and baby during breastfeeding.” So, make like Beyoncé and keep some hot sauce in your bag, swag.
Keep eating: Cow’s milk
While some argue that consuming cow’s milk and other dairy products while breastfeeding can cause your child to develop a milk allergy, experts agree that there’s no reason to restrict dairy unless you’re allergic to it yourself or there’s a family history of dairy allergies (in which case, you can still proceed with caution). According to a 2017 review of studies on maternal food restrictions, an allergy to the protein in cow’s milk (CMPA) is incredibly rare to begin with. What’s more, babies who were exclusively breast-fed were actually less likely to develop CMPA than formula- or mixed-fed infants. Overall, the authors write, “The evidence suggesting that an elimination diet during breastfeeding decreases the development of allergies is weak, whereas the potential for maternal malnutrition is concerning.”
Keep in mind that while there are almost no foods that will be harmful to every baby, individual infants may react differently to certain ingredients. If your baby has discoloration or blood in their stool, it’s possible they’ve had an allergic reaction to something in your breast milk. Talk to your doctor about next steps, which may involve cutting out certain categories of foods for a period of time to see if your baby’s condition improves.
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